• Title/Summary/Keyword: Knee osteoarthritis

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Individualized Traditional Korean Acupuncture for Knee Osteoarthritis : a Protocol for a Randomized Controlled Trial

  • Byun, Hyuk;Baek, Seung-Tae;Park, In-Shik;Kim, Kap-Sung;Kim, Sun-Woong;Choi, Sun-Mi;Lee, Seung-Deok
    • The Journal of Korean Medicine
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    • v.27 no.4
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    • pp.225-232
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    • 2006
  • Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

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The effect of mulligan manual therapy on pain and muscle assessment questionnaire in female elders with osteoarthritis of the knee (멀리건 도수치료가 여성 퇴행성 슬관절염 환자의 통증과 근 기능평가에 미치는 효과)

  • Ma, Sang-Yeol
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.4
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    • pp.641-650
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    • 2010
  • This study was conducted to investigate whether Mulligan manual therapy and Physical therapy have effectiveness on the pain and muscle assessment questionnaire in female elders with osteoarthritis of the knee. Thirty subjects were participated in this study. And they were all randomly divided into Mulligan manual therapy and Physical therapy group. To evaluate the effects of Mulligan manual therapy and Physical therapy, subjects were evaluated by using visual analogue scale and muscle assessment questionnaire. The assessment parameters were evaluated before, after 2 weeks, and after 4 weeks treatments. And we received a consent form from Mulligan manual therapy subjects. The results of repeated measures analysis of variance showed that pain, strength, endurance, coordination/balance were significantly improved after than before therapy in Mulligan manual therapy group. So we conclude that Mulligan manual therapy has effectiveness on the pain and muscle assessment questionnaire in female elders with osteoarthritis of the knee.

Clinical Study on Effect of Rainbow Power Therapy on Osteoarthritis in Knee Joint (Rainbow Power 요법 시술이 퇴행성 슬관절염에 미치는 임상 효능연구)

  • Sung, Hyun-Jae;Kim, Ee-Hwa;Hwang, Jae-Wok;Ryu, Chungr-Yeul
    • Korean Journal of Acupuncture
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    • v.20 no.4
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    • pp.85-98
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    • 2003
  • Objective : This study is designed to find out the effects of Rainbow Power therapy on knee joint with osteoarthritis. Methods : Patient with the osteoarthritis of knee joints are divided into Rainbow Power therapy group(20 people) and none-Rainbow Power therapy group(20 people). After treatment, we evaluated the effect per each group. Results : 1. Fifty and Sixty aged patients were the most in the Rainbow Power group(30% each) and sixty aged patients were the most in the None-Rainbow Power group(45%). 2. In the both groups, 1-3 years duration of disease was the most(40%, 45% each). 3. In the none-Rainbow Power group, patients improved (Lysholm score : $49.20{\pm}11.54{\rightarrow}63.90{\pm}9.54$, p<0.05), but, did not improved in the part of squatting and dystrophy. In the Rainbow Power group, patients improved(Lysholm score : $46.55{\pm}9.89{\rightarrow}80.90{\pm}13.78$, p<0.05), but, did not improved only in the part of dystrophy. 4. The effects of treatment by VNRS were follow : After treatment, $4.10{\pm}1.22$ in Rainbow Power Group and $4.55{\pm}1.15$ in none-Rainbow Power group. 5. The effects of treatment by nine points scale were follow : In the Rainbow Power group, the Excellent was 7 cases(35%), the Good was 9 cases(45%), the Fair was 4 cases(20%) and there was no Poor. The Excellent was 6 cases(30%), the Good was 8 cases(40%), the Fair was 6 cases(30%) and there was no Poor.

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E-mail Survey for Developing Clinical Trial Protocol on Individualized Acupuncture Treatment for Knee Osteoarthritis (무릎 관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 전자우편 설문 조사)

  • Lee, Seung-Deok;Kim, Sun-Woong;Choi, Sun-Mi;Seo, Jung-Chul;Lee, Sang-Hoon;Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.197-204
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    • 2005
  • Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture prescriptions for knee osteoarthritis in real clinical practice. Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. The questionnaires were distributed via e-mail to 3,306 members of Korea Oriental Medical Association from March 15th to March 23rd in 2005.84 members completed answers, and the computerized data were analyzed by ISP statistical program. Results : 1. 68 out of 84 Korean medical doctors used pattern diagnosis. 2. 61 out of 84 Korean medical doctors used both local and remote points, 20 doctors remote points only, and 3 doctors local acupuncture points only. 3. In case of doctors who use remote acupuncture points only, the acupuncture prescription principle was Saam or five element acupuncture (66%), along the meridian pathway (14%), Eight constitutional acupuncture (11%), Taegeuk acupuncture (2%), and miscellaneous (18%). Conclusion : In our e-mail survey, Korean medical doctors who experienced more than 10 year practice answered that they use five element acupuncture or Saam acupuncture according to meridian pathway theory as the most common principle of their acupuncture treatment prescription.

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Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain

  • Ghai, Babita;Kumar, Muthu;Makkar, Jeetinder Kaur;Goni, Vijay
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.183-190
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    • 2022
  • Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

Adductor canal block versus intra-articular steroid and lidocaine injection for knee osteoarthritis: a randomized controlled study

  • Ming, Lee Hwee;Chin, Chan Soo;Yang, Chung Tze;Suhaimi, Anwar
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.191-201
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    • 2022
  • Background: This study aimed to assess the efficacy of the adductor canal block (ACB) in comparison to intra-articular steroid-lidocaine injection (IASLI) to control chronic knee osteoarthritis (KOA) pain. Methods: A randomized, single-blinded trial in an outpatient rehabilitation clinic recruiting chronic KOA with pain ≥ 6 months over one year. Following randomization, subjects received either a single ACB or IASLI under ultrasound guidance. Numerical rating scale (NRS) scores for pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were recorded at baseline, 1 hour, 1 month, and 3 months postinjection. Results: Sixty-six knees were recruited; 2 were lost to follow-up. Age was normally distributed (P = 0.463), with more female subjects in both arms (P = 0.564). NRS scores improved significantly for both arms at 1 hour, with better pain scores for the IASLI arm (P = 0.416) at 1st month and ACB arm at 3rd month (P = 0.077) with larger effect size (Cohen's d = 1.085). Lower limb function improved significantly in the IASLI arm at 1 month; the ACB subjects showed greater functional improvement at 3 months (Cohen's d = 0.3, P = 0.346). Quality of life (QoL) improvement mirrored the functional scores whereby the IASLI group fared better at the 1st month (P = 0.071) but at the 3rd month the ACB group scored better (Cohen's d = 0.08, P = 0.710). Conclusions: ACB provides longer lasting analgesia which improves function and QoL in chronic KOA patients up to 3 months without any significant side effects.

Effects of Tai Chi Exercise in Elderly with Knee Osteoarthritis (슬골관절염 노인환자의 타이치운동 효과)

  • Lee, Hea-Young;Lee, Keum-Jae
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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    • pp.11-18
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    • 2008
  • Purpose: This study was to determine whether the Sun-style 24 forms of Tai Chi exercise improve pain, stiffness, disability, knee joint motion, mobility, balance or falling. Method: Forty-six community-dwelling elderly subjects (mean age, $75.46{\pm}6.28$) voluntarily participated in an intervention group of either 24 forms of Sun-style T ai Chi for 60 min, 2 times per week for 12 weeks or a control group. A non-equivalent pretest-posttest design was used. Independent t-test and ANCOVA were used to examine group differences by using SPSS12.0. Result: The experimental group had significantly less pain (F=7.60, p=.008) and stiffness (t=-3.19, p=.003) than the control group. Also there were significant improvements in knee joint motion on the right knee (t=2.44, p=.019), left knee (t=2.30, p=.026), rising time (F=8.03, p=.07), balance on the left single leg test (t=2.20, p=.033), and fear of falling (t=-2.33, p=.024) in the Tai Chi exercise group. No significant group differences were found in disability and falls efficacy. Conclusion: The Sun-style 24 forms Tai Chi exercise is effective in decreasing pain, stiffness, fear of falling and it improves balance, rising time, and knee joint motion. We suggest a continuing long term intervention to decrease disability and increase efficacy concerning falls.

Comparison of Knee Muscle Strength and Endurance of Affected Legs of Korean Women Diagnosed with Kellgren-Lawrence grade (K-L II) by Age

  • Hong, Soung-Kyun;Lee, Dong-Geon;Song, Sun-Hae;Lee, Seung-Hoo;Shin, Doo-Chul
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.4
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    • pp.1-8
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    • 2019
  • PURPOSE: The purpose of this study was to compare the maximum knee strength and endurance of elderly Korean women with Kellgren-Lawrence grade (K-L II) by age. METHODS: In this study, the total number of participants was 50, divided into five groups of 10 by age. Maximum knee muscle strength was measured at a low speed of 60°/sec using Biodex, an isokinetic device for comparison of maximum knee muscle strength, whereas muscle endurance was measured by muscle contraction at a high speed of 180°/sec. The peak torque values of the extensor and flexor muscles in the muscle strength and muscle endurance tests were collected according to each classification. RESULTS: The results of the experiment show that maximum muscle strength and muscle endurance decreased significantly at 60°/sec and 180°/sec during flexion and extension according to age (p<.05). In particular, the age group of 71 to 75 years showed the most significant correlation with other age groups (p<.05). CONCLUSION: The results of this study can be used as basic data for increasing physical activity and muscle strength in women with knee osteoarthritis.

The Clinical Study on Correlation between Knee Osteoarthritis and Obesity (퇴행성 슬관절염과 비만과의 상관성에 관한 임상 연구)

  • Kang, Jung-Won;Ryu, Seong-Ryong;Seo, Byung-Kwan;Cho, Mi-Ran;Cho, Ryo-Won;Woo, Hyun-Su;Lee, Sang-Hoon;Choi, Do-Young;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Yun-Ho;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.22 no.6
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    • pp.17-26
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    • 2005
  • Objectives : The purpose of this study is to investigate the correlation between assessment measurements of knee osteoarthritis and obesity. Methods : Data on assessment measurements of knee osteoarthritis and obesity were obtained from 63 patients suffering from knee osteoarthritis from February to April, 2005. The assessment measurements consisted of BMI (body mass index), WHR (waist-hip ratio), two disease-specific questionnaires (Western Ontario and McMaster Universities (WOMAC) index and Lequesne's Functional Severity Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), and VAS (Visual Analogue Scale). Statistical correlations among assessment measurements were evaluated by examining the Pearson's correlation coefficients. Results : 1. The sexual ratio in this study was 1: 5.3 (male: female= 10: 53). The average age of all patients was $59.1{\pm}6.6$ (male: $58.3{\pm}7.1$, female: $59.2{\pm}6.5$), and the group of 60-69 (34 patients, 54%) was biggest in the age distribution. 2. The average BMI of all patients was $25.4{\pm}3.1\;kg/m^2$ (male: female= $23.6{\pm}2.6\;kg/m^2:\;25.8{\pm}3.0\;kg/m^2$), and the group of $20-25\;kg/m^2$ was biggest in the BMI distribution. According to clinical definition of obesity by WHO (1997), 52.4% of all patients was within normal weight, 42.9% was overweight, and 4.8% was obese. 3. The average WHR of all patients was $0.91{\pm}0.06$ (male: female= $0.90{\pm}0.05:\;0.92{\pm}0.06$). According to definition of abdominal obesity, 73.0% of all patients (46 patients were all female) was in the state of abdominal obesity. 4. There were no significant correlations in statistics among assessment measurements except between BMI and WHR. Conclusion : Though there is significant correlation between knee osteoarthritis and obesity according to many clinical and experimental researches, there is no assessment measurement reflecting knee osteoarthritis and obesity simultaneously. For this, further studies on correlation between knee osteoarthritis and obesity and development of assessment measurement or questionnaire on this are needed.

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The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.